Introduced by Representatives
Tracy of Burlington, Trombley of Grand Isle, Bohi of Hartford, Botzow of
Pownal, Brooks of Montpelier, Chen of Mendon, Connell of Warren, Cross of
Winooski, Donovan of Burlington, Edwards of Brattleboro, Fisher of Lincoln,
Gervais of Enosburg, Jewett of Ripton, Johnson of South Hero, Kenyon of
Bradford, Klein of East Montpelier, Larson of Burlington, Maier of Middlebury,
McLaughlin of Royalton, Milkey of Brattleboro, Nease of Johnson, Nuovo of
Middlebury, Partridge of Windham, Pillsbury of Brattleboro, Pugh of South
Burlington, Shand of Weathersfield, Sharpe of Bristol, Smith of Morristown and
Sweaney of Windsor

Referred to Committee on

Date:

Subject: Health;
prescription drugs; reimportation

Statement of purpose: This
bill directs the department of prevention, assistance, transition, and health
access (PATH) to establish a program to provide for and facilitate the purchase
of prescription drugs from Canada.

AN ACT RELATING TO THE PURCHASE OF PRESCRIPTION DRUGS FROM CANADA

It is hereby enacted by the
General Assembly of the State of Vermont:

Sec. 1. 33 V.S.A. §§ 2007
and 2008 are added to read:

§ 2007. CITIZENS’ PRESCRIPTION
DRUG PURCHASING PROGRAMFROM
CANADA

(a)
On or before January 1, 2005, the department of prevention, assistance, transition,
and health access shall establish a program to enable Vermont
residents, including Medicaid recipients, to purchase from Canada prescription
drugs manufactured in the United
States. For the purposes of
this section, “Medicaid recipients” includes any individual who participates in
Medicaid or any Medicaid waiver program, including the Vermont
health access plan, Dr. Dynasaur, Healthy Vermonters, VHAP pharmacy, VScript or

VScript-Expanded.

(b)
The program shall provide:

(1)
information, including drug pricing, about procuring from Canadian sources prescription
drugs manufactured in the United States through the mail, from local pharmacies,
or otherwise; and

(2)
the necessary forms and contact information for procuring from Canadian
sources prescription drugs manufactured in the United States.

(c)
The department shall establish a website and provide written information
regarding the program.

(d) The commissioner
shall offer a request for proposals to prescription drug wholesalers whose
primary place of business is in Vermont to participate in the program. The
commissioner shall offer a $10.00 transaction fee for any pharmacy who elects
to participate in the program whose primary place of business is in Vermont.

(e) If no wholesaler elects
to participate, the commissioner shall set up a program directly with Canadian
sources. The commissioner shall:

(1) offer a request for
proposals directly to Canadian sources soliciting physicians and pharmacies who
wish to participate in the program;

(2) appoint a panel of
health care professionals, including at least two physicians, two pharmacists,
and one member each of the professional conduct boards for physicians and
pharmacists to investigate and review the proposals to ensure that the Canadian
sources are safe;

(3) require that any
participating physicians or pharmacists be licensedby a Canadian
province whose licensing requirements are deemed to be substantially equal to
those of this state;

(4) establish a
relationship with at least one Canadian physician to prescribe the medication
in conjunction with the Vermont resident’s physician and at least five Canadian
pharmacies to allow consumers a choice of pharmacy.

(f) The commissioner
may implement the prescription drug purchasing program for any other health
benefit plan within or outside this state that agrees to participate in the
program. The commissioner shall work with the commissioners of corrections,
developmental disabilities and mental health services, and personnel to
establish the state prescription drug purchasing program authorized in section
2008 of this title.

(g)
The commissioner shall adopt rules as necessary to allow participants in the
Medicaid and Medicare programs to apply the costs of prescription
drugs purchased outside this country toward any deductibles or spend-down
amounts required by those programs.

§ 2008. STATE PRESCRIPTION DRUG PURCHASING PROGRAM

(a) The commissioners
of prevention, assistance, transition, and health access; corrections; developmental
disabilities and mental health services; and personnel shall negotiate for the
purchase from Canadian sources of prescription drugs manufactured in the United
States so that individuals under the supervision of the department of
corrections, individuals under the supervision of the department of
developmental disabilities and mental health services, and beneficiaries of a
health benefit plan, as defined in subdivision 1997(4) of this subchapter,
covering employees, including retirees, who have a valid prescription, may procure
prescription drugs at reduced prices.

(b) The commissioners shall
offer a request for proposals to prescription drug wholesalers whose primary
place of business is in Vermont to procure from Canadian sources the prescription
drugs manufactured in the United States. If no wholesaler
participates, the commissioners shall negotiate directly with Canadian sources.

(c) The commissioner of
personnel shall offer a financial incentive for state employees and retirees who
purchase prescription drugs through the state prescription drug program
established by the section.

(d) A municipality or
school board may negotiate for the purchase from Canadian sources of
prescription drugs manufactured in the United States so that beneficiaries
of a health benefit plan, as defined in subdivision 1997(4) of this subchapter,
covering employees, including retirees, who have a valid prescription may procure
prescription drugs at reduced prices.

(a) The commissioner of prevention, assistance,
transition, and health access shall establish a pharmacy best practices and
cost control program designed to reduce the cost of providing prescription
drugs, while maintaining high quality in prescription drug therapies. The
program shall include:

(1) A preferred list of covered
prescription drugs that identifies preferred choices within therapeutic classes
for particular diseases and conditions, including generic alternatives. Any
brand-name prescription drug made by a company that limits its supply of
prescription drugs to Canada shall not be included on the preferred list if
a safe, equivalent drug is otherwise available.

Sec.
3. 8 V.S.A. § 4089i is added to read:

§ 4089i. PRESCRIPTION
DRUG COVERAGE

(a) A health insurance or other health
benefit plan offered by a health insurer shall count the costs of prescription
drugs purchased outside this country toward any deductibles on the same terms
and conditions as prescription drugs purchased in this country.

(b) As used in this section, “health
insurer” is defined by subdivision 9402(9) of Title 18.

Sec. 4. 26 V.S.A. § 2042(b) is amended to read:

(b) The board may license by endorsement an applicant
who is licensed under the laws of another state or a province
of Canada whose requirements the board deems to be
substantially equal to those of this state.

Sec.
5. RECODIFICATION DIRECTIVE

It is the intent of
the general assembly to retain without modification the substantive provisions
of 8 V.S.A. § 4089i, relating to “health care ombudsman,” as existed prior to
this act. It is also the intent of the general assembly to add provisions
relating to prescription drug coverage to subchapter 1 of chapter 107 of Title
8, relating to health insurance generally. Therefore, the legislative council,
pursuant to its revision authority in 2 V.S.A. § 424, is directed to recodify 8
V.S.A. §§ 4089i and 4089j to be 8 V.S.A. §§ 4089v and 4089w, respectively, or
other recodification or renumbering the legislative council deems appropriate,
to retain without change those sections as a separate subchapter 1A of chapter
107 of Title 8 pertaining to “Health Care Ombudsman.” The substantive
provisions of Sec. 3 of this act relating to prescription drug coverage shall
be codified as part of subchapter 1 of chapter 107 of Title 8, to be
designated as section 4089i of Title 8, or other numeration as determined by
the legislative council.

Sec. 6. EFFECTIVE DATE; APPLICABILITY

This act shall take effect July 1, 2004,
except that the provisions of Sec. 2 of this act, relating to the pharmacy best
practices control program, shall apply to health benefit plans as they are
offered, issued, or renewed after July 1, 2004, but in no event later than
January 1, 2005.